MONTANA EFFECTIVE FINANCING STATEMENT FORM EFS Filing Fee = $7.00 Send Acknowledgement To: Return Name: Return Address: This space is for filing use only Contact Name: Contact Phone Number: 1. Debtor's Exact Full "Legal" Name - only one debtor name (1a or 1b) 1a. Organization Name or 1b. Individual's Last Name First Name 1c. Mailing Address 1d. SSN or Tax ID# City State Middle Name Postal Code Suffix Country 1e. Debtor's Signature, Authorization, or Authentication 2. Debtor's Exact Full "Legal" Name - only one debtor name (2a or 2b) 2a. Organization's Name or 2b. Individual's Last Name First Name 2c. Mailing Address 2d. SSN or Tax ID# City State Middle Name Postal Code Suffix Country 2e. Debtor's Signature, Authorization, or Authentication 3. Secured Party's Exact Full "Legal" Name ­ only one secured party name (3a or 3b) 3a. Organization's Name or 3b. Individual's Last Name First Name 3c. Mailing Address City Middle Name State Postal Code Suffix Country This lien notice must be filed by the Secured Party in compliance with the Federal Act. The following table is for specific Farm Products only Specific Farm Product Crop Year Montana County Farm Product Quantity/Description Proceeds Covered (Check box if proceeds are covered) http://sos.mt.gov/Business/forms/EFS/EFS_Filing_Form.pdf Products Covered (Check box if products are covered) Revised: 09/20/2012 American LegalNet, Inc. www.FormsWorkFlow.com INSTRUCTIONS FOR COMPLETING EFFECTIVE FINANCING STATEMENT FORM PLEASE TYPE THIS FORM: At least a 10-point font must be used when completing the form. VERIFY INFORMATION: Verify all information you enter on the form for accuracy and correct spelling. Any error may result in your lien becoming ineffective. DEBTOR NAME (1a or 1b,2a or 2b): Enter only one Debtor name per section. The debtor name can be an organization or an individual's name but it cannot be both. Enter Debtor's exact full legal name. Do not abbreviate. DEBTOR ADDRESS (1c or 2c): Enter the debtor's mailing address including city, state and zip code. ORGANIZATION DEBTOR: "Organization" means an entity having a legal identity separate from its owner. A partnership is an organization; a sole proprietorship is not an organization, even if it does business under a trade name. If the Debtor is a partnership, enter exact full legal name of partnership. If Debtor is a registered organization (e.g., corporation, limited partnership, limited liability company), it is advisable to examine Debtor's current filed charter documents to determine debtor correct name. INDIVIDUAL DEBTOR: "Individual" means a natural person; this includes a sole proprietorship, whether or not the individual is operating under a trade name. Do not use prefixes (Mr., Mrs., Ms.). Use suffix box only for titles of lineage (Jr., Sr., III) and not for other suffixes or titles (e.g., M.D.). Use a married woman's personal name (Mary Smith, not Mrs. John Smith). Enter individual Debtor's family name (surname) in the Last Name box, first given name in the First Name box, and all additional given names in the Middle Name box. TAX ID NUMBER (1d and 2d): The SSN is required for each individual debtor and the debtor's internal revenue service (IRS) employer identification number is required for each business, corporation and trade name. DEBTOR SIGNATURE (1e and2e): Each debtor reflected on the EFS is required to sign, authorize or authenticate the notice. SECURED PARTY NAME (3a or 3b): Enter the secured party's name in either 1e or 2e but do not complete both fields. SECURED PARTY ADDRESS (3c): Enter the secured party's mailing address including city, state and zip code. SECURED PARTY: The secured party is required to file the lien notice with the Secretary of State's office. SPECIFIC FARM PRODUCT: You must list the specific farm product such as wheat, barley, hay, cattle, horses, and pigs. The listing all "livestock and crops" will not suffice. CROP YEAR: For a crop grown in soil, list the calendar year in which it is harvested or to be harvested. For animals, list the calendar year in which they are born or acquired. For poultry or eggs, list the calendar year in which they are sold or to be sold. If "year" is left blank, perfection continues for every year the statement is effective. COUNTY: List where the farm product is produced and/or located. QUANTITY/DESCRIPTION: Number of bushels, head of livestock, or other commonly used identifier. Specify the units. Example: 300 bushels of winter wheat stored in bin 12. If "quantity/description" is left blank, then all specific farm products owned by the debtor are covered. LIEN DURATION: An EFS lien is effective for a period of five years unless extended by filing a continuation statement ACKNOWLEDGEMENT LETTER: A system derived acknowledgement letter will be returned to you to retain with your records. Please verify the information appearing on the acknowledgement letter for accuracy and correct spelling. If you discover a problem, please contact our office immediately at (406) 444-2468. EFS FILING FEE: Effective Financing Statement = $7.00 PHYSICAL/MAILING ADDRESS: Montana Secretary of State, Attn: UCC, 1301 6th Avenue, State Capitol, 2nd Floor, Room 206, Helena, MT. 59601 or PO Box 202801, Helena, MT. 59620-2801 REVISED ARTICLE 9 PROTECTION: To establish perfection and priority under UCC Revised Article 9 (RA9) you must complete the UCC national form in addition to the EFS Form. The EFS form provides protection only to third party buyers of the farm product. Creating protection from other creditors requires you to file the national UCC form. WEB ADDRESS: sos.mt.gov FAX NUMBER: (406) 444-3976 http://sos.mt.gov/Business/forms/EFS/EFS_Filing_Form.pdf Revised: 09/20/2012 American LegalNet, Inc. www.FormsWorkFlow.com